Percutaneous Balloon Rhizotomy for Trigeminal Neuralgia Using Three-Dimensional Fluoroscopy

Olivero, William C.; Wang, Huan; Rak, Richard A.; Sharrock, Matthew F.

doi:10.1016/j.wneu.2011.03.041

Cited by 11 publications

(5 citation statements)

References 19 publications

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“…The CT-guided procedure is a technical variation that should be considered for patients with difficult puncture due a distorted anatomy, as in cases of osteogenesis imperfecta or ossification of the pterygoalar (Hyrtl) ligament, prior trauma or multiple previous attempts [7, 10-12]. Three-dimensional rotational fluoroscopy has been described as an option [13] but it requires specific training that is not part of the routine of specialists in functional neurosurgery. Intraoperative mobile CT coupled or not to a neuronavigation system is another option with good results [14], but this technology is not available at many neurosurgery services in the world.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Foramen Ovale Puncture: Usefulness of Intraoperative CT Control, in the Eventuality of a Narrow Foramen

Mendes¹,

Cunha²,

Monteiro³

et al. 2020

Stereotact Funct Neurosurg

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Background: Balloon compression of the gasserian ganglion has been a well-established percutaneous treatment of trigeminal neuralgia since the 1980s. However, puncture of the foramen ovale by conventional single-plane fluoroscopy can be difficult in cases of local anatomic abnormalities. Case Presentation: We present the case of a 49-year-old woman diagnosed with idiopathic trigeminal neuralgia refractory to pharmacological treatment. After failure of puncture by conventional fluoroscopy for percutaneous gasserian ganglion balloon compression due to a narrow foramen ovale, the patient was submitted to puncture guided by computed tomography. Conclusion: Alternative imaging methods, such as computed tomography, should be considered when puncture of the foramen ovale by conventional single-plane fluoroscopy fails, to minimize the risk of potential complications triggered by frustrated puncture attempts.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Foramen Ovale Puncture: Usefulness of Intraoperative CT Control, in the Eventuality of a Narrow Foramen

Mendes¹,

Cunha²,

Monteiro³

et al. 2020

Stereotact Funct Neurosurg

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“…Van Gompel et al 20 performed the first Dyna-CT scan to determine the relationship of the balloon to Meckel's cave. Olivero et al 9 pointed out that 3D rotational fluoroscopy is an important adjunct for treating TN via percutaneous techniques. A few small case studies have described the use of Dyna-CT in PMC, but analysis of the balloon volume during compression was rarely presented.…”

Section: Discussionmentioning

confidence: 99%

“…Dyna-CT helps visualize the FO and allows easier cannulation of it 9. It allows visualization of the tip of the needle in the FO and also the size and shape of the inflated balloon.…”

Section: Introductionmentioning

confidence: 99%

Dyna-CT-assisted percutaneous microballoon compression for trigeminal neuralgia

Huo

Sun

Zhang

et al. 2013

J NeuroIntervent Surg

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Dyna-CT performed by digital subtraction angiography assists PMC in three ways: (1) the FO can be better visualized independent of the patient's position; (2) needle correction or insertion can be performed much more easily because of the direct fluoroscopic control; and (3) the needle position, balloon position, balloon configuration and the volume of the inflated balloon is more reliably determined. The use of Dyna-CT-assisted PMC has a low incidence of complications and a good prognosis.

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“…As mentioned earlier, the second landmark is the guidance of the HI, which should be the bisector of the angle formed by the clivus and the superior edge of the petrous bone. To reduce the bad steering, some authors recommended for targeting the use of three-dimensional fluoroscopy,[32] neuronavigation[8] or three-dimensional axial tomography reconstructions. [2738]…”

Section: Discussionmentioning

confidence: 99%

Technical considerations and outcome assessment in retrogasserian balloon compression for treatment of trigeminal neuralgia. Series of 901 patients

Abdennebi¹,

Guenane²

2014

Surg Neurol Int

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Background:The aim of our study was to describe the retrogasserian balloon compression (RGBC) procedure with some personal tricks and to assess the long-term results.Methods:Between 1985 and 2012, 901 patients, suffering from refractory trigeminal neuralgia (TN), underwent RGBC procedure in our department. Concerning the surgical technique, the introducer was in close contact with the posterior extremity of the horizontal plate of the palatine bone and had the direction of the bisector of the angle clivus-superior edge of the petrous bone on an X-rays sagittal view. No metallic material was inserted intracranially. The balloon was inflated with 0.7 cc of contrast medium for 6 min.Results:At 1 month follow up, appreciable pain relief was obtained in 835 patients (92.7%). At 1 year, results were excellent in 605 patients (67.1%), satisfactory in 109 patients (12.1%), poor in 57 patients (6.3%), fair in 66 patients (7.3%), whereas recurrences were observed in the remaining 64 patients (7.2%). At mean follow up of 16,5 years, 559 (62%) patients remained pain free. Twenty six patients (2,8%) continued to experience severe pain. Recurrences occurred in two hundred and fifty patients (27,8%). Fifty two of them were operated on a third time and 22 underwent four procedures.Conclusion:RGBC is an appropriate and effective procedure for treatment of refractory TN, ensuring a long lasting pain relief predicted on three factors: pear shape of the balloon, its volume, and duration as mentioned earlier.

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Percutaneous Balloon Rhizotomy for Trigeminal Neuralgia Using Three-Dimensional Fluoroscopy

Cited by 11 publications

References 19 publications

Percutaneous Foramen Ovale Puncture: Usefulness of Intraoperative CT Control, in the Eventuality of a Narrow Foramen

Percutaneous Foramen Ovale Puncture: Usefulness of Intraoperative CT Control, in the Eventuality of a Narrow Foramen

Dyna-CT-assisted percutaneous microballoon compression for trigeminal neuralgia

Technical considerations and outcome assessment in retrogasserian balloon compression for treatment of trigeminal neuralgia. Series of 901 patients

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